Editorial: Global health initiatives and the new dichotomy in health systems.

The WFPHA proposes to lead a discussion about global aid and Global Health Initiatives (GHIs), beginning in these Federation Pages. In this issue (JPHP 31.1), we have invited authors from the Department of Public Health from the Institute of Tropical Medicine Antwerp, Belgium, and from the Federal Ministry of Health, Addis Ababa, Ethiopia to discuss the ‘New dichotomy in health systems’ strengthening and the role of global health initiatives’. Next, the WFPHA will take a very active part in the upcoming Geneva Forum, 19–21 April 2010, entitled Globalization, Crisis & Health Systems: Confronting Regional Perspectives (http://www.ghf10.org/). The problems of GHIs will be the topic of a special session. In it, the organisers will integrate views of researchers, such as the contributors here, along with those of GHIs professionals, and participants from recipient countries. The questions underpinning foreign aid are many, and cover a wide area. We have to look at the ethical and moral assumptions behind the belief that foreign aid ‘does good’. We must ask: ‘Where has aid failed?’ and then explain why. As has Roger Riddell, we will ask not only if aid works, but also, ‘Is it needed?’. GHIs and foreign aid remain fragmented, suffering from lack of coordination among donors. The under-resourced, local governments are burdened by duplicative reporting requirements, with each donor insisting upon different forms and formats to collect the same sorts of information. Even after the international consensus conferences in Paris